Hi I was diagnosed with under active thyroid in 2014.been on levothyroxine since then.Just had some bloods done my renal function was below what it should be.Looking back through my levels over last 10 years it appears never been normal range apart from prior to me taking Levothyroxine.Anyone else had similar issue. Gp has only just noticed
Can Levothyroxine alter kidney function? - Thyroid UK
Can Levothyroxine alter kidney function?
Written by
Jmthomas55
To view profiles and participate in discussions please or .
Read more about...
24 Replies
•
TiggerMeAmbassador
Welcome aboard
Usually kidney function improves when on the right dose of thyroid hormones... How are you feeling? Have you any recent blood test results you can share, with ranges as they vary between labs
Ideally TSH, fT3 and fT4
Thyroid levels are within normal range,I feel fine blood tests show abnormal gfr and creatinine,but when you look back they have been out of range since I started levothyroxine 10 years ago.Albiumin in urine so have to repeat that to.Thanks for responding
I'm afraid 'normal' doesn't do it for us the ranges are far too wide, we aim for optimal which can be quite different, so it sounds like you have been under-replaced since the start which isn't unusual 🫤
Like I say, show us some past results also if you have any for folate, ferritin, B12 and Vit D
My dose 75 one day 50 the next
Vit D level60 on daily supplement
B12 474
Ferritin 91
Follate 10.28
Tsh now 1 .43
was 23 at diagnosis then has been anything from 0.05 to 4.45 fluctuates was very sensitive to thyroxine at start as put on too high a level.
Iam interested to know if anyone has had abnormal renal function when taking thyroxine and if there's a link
That’s a very very low dose levothyroxine
Are you male or female
Approx weight
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
is this how you do your tests?
How long also were these vitamins tested
Are you in U.K.?
Vitamin D - if units are nmol …..60nmol is too low
B12, folate also too low
What vitamin supplements are you taking
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Post all about what time of day to test
healthunlocked.com/thyroidu...
Testing options and includes money off codes for private testing
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Only do private testing early Monday or Tuesday morning.
Tips on how to do DIY finger prick test
So no results for freeT4 and freeT3 which are important to see where your levels are and how well you are converting to the active fT3... your TSH is a little high suggesting your current dose is too low
SlowDragon has been really thorough with her replies which might take you a rainy Sunday to work through so I shall just add that it is low fT3 that effects kidney function so as it certainly looks like you would be better on a 75/100 dose for your size and hopefully that would give your system enough fT3 and improve your kidney function.
I myself had very poor kidney function on levo until I added T3 77 to <90 (80 pre levo)
also my creatinine levels dropped from 76 to 56 (70 pre levo)
I'm a poor converter hence the need for a combination of T3 & T4, which maybe the case for you, it isn't Levo that causes kidney issues it's the lack of fT3 possibly due to low dose Levo or lack of conversion
Hope that helps
Just looking back at my albumin levels which have always been on the low side, (though a good mid range one last year) and reminded myself that low zinc (which I also had and is common with Hypos) is linked with low albumin levels...
How are your liver results looking? Have you been tested for celiac disease?
My albumin is high in urine.Yes was tested for coeliac when began levothyroxine as had similar symptoms .weight loss,diarrhea, etc
I started on 50 levothyroxine went up gradually to 100 symptoms all improved when dropped dose.
The higher dose caused me to become over active
I do take daily vitamin c supplement with zinc and the vit d.
Lft results all within range.
I only ever get serum tsh result with blood test .
I have also wandered whether my initial diagnosis in 2014 was incorrect,the serum tsh was 23 prior to that it was stable at 3.45
Then huge jump to 23,wish I had realised and questioned it then and asked for retest before starting meds
Sounds like classic Hashimoto Autoimmune with fluctuating levels, have they checked your antibodies?
I'd recommend getting a full thyroid panel and go from there as at the moment we are in the dark without a torch
SlowDragonAdministrator
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Most important results are ALWAYS Ft3 followed by Ft4 …..not just TSH
cks.nice.org.uk/topics/hypo...
bnf.nice.org.uk/drugs/levot...
nhs.uk/medicines/levothyrox...
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
sciencedirect.com/science/a...
The optimal daily dose in overt hypothyroidism is 1·5–1·8 μg per kg of bodyweight, rounded to the nearest 25 μg.
SlowDragonAdministrator
Low thyroid levels, especially low Ft3 strongly linked to low GFR
pmc.ncbi.nlm.nih.gov/articl...
The GFR is reversibly reduced (by about 40%) in more than 55% of adults with hypothyroidism[40]
Hypothyroidism results in a reversible elevation in serum creatinine due to the reduction in GFR as well as possible myopathy and rhabdomyolysis. There is a reduction in serum cystatin C levels in hypothyroidism due to reduced production, consequent to reduced cellular metabolism.[30] Both these changes are reversible with treatment of hypothyroidism. Hypothyroidism also results in increased glomerular capillary permeability to proteins.[47] The consequent proteinuria often precedes the reduction in GFR in hypothyroidism.[48]
Iam female weigh 55kg I couldn't tolerate higher dose started on 50 went up to 100 didn't suit me ended up overactive and under weight this current dose does suits me.Its taken ages to find what works for meInterested to read this re gfr and thyroid,Gp has only just noticed my renal function below range.
started on 50 went up to 100 didn't suit me ended up overactive
That was far too large an increase in one go …..but now probably on too low a dose
Suggest you work on improving low vitamin levels
Retest thyroid and vitamin levels again in further 8 weeks
Testing thyroid as outlined above
guidelines suggest somewhere around 88mcg daily likely necessary
Which brand of levothyroxine are you taking
Do you always get same brand at each prescription
SlowDragonAdministrator
GP will often only prescribe to bring vitamin D levels to 50nmol.
Some areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Test twice yearly when supplementing
Can test via NHS private testing service
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.
There’s a version made that also contains vitamin K2 Mk7.
One spray = 1000iu
amazon.co.uk/BetterYou-Dlux...
It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average
Vitamin D may prevent Autoimmune disease
newscientist.com/article/23...
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Recipe ideas
bbc.co.uk/food/articles/mag...
Interesting article by Dr Malcolm Kendrick on magnesium
drmalcolmkendrick.org/categ...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
SlowDragonAdministrator
only add/change one vitamin supplement at a time
Wait 10-14 days to assess before adding another
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Highly effective B12 drops
natureprovides.com/products...
Or
B12 sublingual lozenges
uk.iherb.com/pr/jarrow-form...
cytoplan.co.uk/shop-by-prod...
In-depth article on different forms of B12
perniciousanemia.org/b12/fo...
B12 range in U.K. is too wide
Interesting that in this research B12 below 400 is considered inadequate
healthunlocked.com/thyroidu...
perniciousanemia.org/b12/le...
And why aiming to keep B12 over 500 recommended
perniciousanemia.org/b12/le...
Great reply by @humanbean on B12 here
healthunlocked.com/thyroidu...
Low folate
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
healthline.com/nutrition/fo...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need separate methyl folate couple times a week
Post discussing different B complex
healthunlocked.com/thyroidu...
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Post discussing how biotin can affect test results
After reading about the link between deteriorating kidney function and hypothyroidism I asked for a urine analysis. This showed proteinuria (albuminuria), an indicator of kidney damage. Also, GFR was low and historically below 90 range. I'm hoping now I'm on Levothyroxine (112.5 mcg) I'll see an improvement in kidney function. Having a follow-up urinalysis soon. Perhaps you are still hypothyroid?
Least I'm not only one
My FT3 was on the bottom of the interval (or below) when I was on Levo only. TSH and FT4 were "normal". The eGFR was consistently below interval until I started to take T3. That's when the eGFR moved into normal range. I wonder whether it would be helpful to see where your FT3 is within the interval. If it is at the lower end of the interval, that could be at least a contributing factor for a lower eGFR. Optimal thyroid levels positively influence metabolism, which leads to better blood flow and thus the kidneys' ability to filter blood more efficiently. Since you seem to be satisfied with your Levo dose and feeling well, it is, of course, possible that there is a different cause for the low eGFR. I have doubts that it is caused by the Levothyroxine, but, of course, since we all are different, I might be wrong. It's worth investigating.
Not that I was aware, but that is real interesting. I know a year after being on Levo I had low grade elevated BP which I was never ever even close and BP drugs will alter kidney function. Thank You
I’ve read that it’s quite common for people with thyroid conditions to have slightly higher creatinine levels, which is my case…whether this is causation of the condition itself or meds or adequate meds or not I don’t know … I have juggled about with my meds (T4 & T3) and no change overall… I saw on my notes CKD 3 but was never told , apparently they think this is my normal as I’ve been like this for well over a decade … I’ve since had scans and annual blood urine checks but nothing found, just to make sure … not had MRI which could potentially give more information.
My own experience leads me to suspect there is a link between thyroid disorders and kidney function. But I was diagnosed with CKD at the same time as thyroid issues and had never taken levothyroxine before that. Is it possible that your kidney function had been compromised before you even started on the medication? My understanding is that it can be a long process of decline and isn’t always evident unless specifically tested. Mine was found after a diligent intern did lots of general tests. It was a bit of a double whammy at the time
I've had an underactive thyroid for 30 years and noticed on a blood test that my kidney result was out of range. I don't know what your age is but when I googled and asked whether my result was normal for my age it said it was. I am aged 77. I presume as we get older the norm for our age can change too.
As we get older, our kidney function declines, it is a natural process. GFR typically begins to decline around age 30–40 and declines by about 1 ml/min/m2 per year. By age 70, more than 40 ml/min/m2 of GFR can be lost. Normal GFR levels for healthy people under 70 are generally above 60 mL/min/1.73 m2, but values below this could be considered normal for people over 70.
Thyroid disease is a metabolic disorder, that means that if you are hypothyroid, your body has not got enough hormones for your metabolism to work efficiently. Part of that can be that your glucose levels could be higher, some people have slightly higher cholesterol levels (or quite high, depending on how hypothyroid they are).
Hypothyroidism is associated with higher serum creatinine levels. This is likely due to a decrease in the glomerular filtration rate (GFR). Other effects of hypothyroidism on the kidney include decreased renal blood flow and changes in water and electrolyte metabolism. However, once you are on the correct dose of replacement, this should correct itself.
Albumin metabolism is prolonged in hypothyroidism, and thyroid hormone promotes albumin metabolism. So when you have too little thyroid hormones to work with, albumin levels can rise, but again this can be corrected with the right dose.
As others have suggested, TSH alone will not give you an idea where your T4 or T3 levels are and especially T3 has a great influence on your metabolism - so even if your TSH is within range, your T3 could still be low and that has an impact on your overall metabolism.
It would certainly be worth doing a private blood test to check TSH, T4 and T3 so you have a better idea where the exact levels of these two important hormones are.
Not what you're looking for?
You may also like...
Kidney function and hypothyroidism?
My hypothyroidism was finally acknowledged six weeks ago. I've been on 50mcg daily. I've just had...
Decreased Kidney Function on Levo?
Hi folks.
My Kidney function (GFR) has decreased quite rapidly since taking Levothyroxine...
Kidney function and hypothyroidism
Following on from my g.p visit this evening, and my previous posts, I have a print out of my...
Hypo and Kidney function?
My daughter has been hypo for some years, on increasing levels of T4 but remaining fatigued and...
Kidney function and thyroid
My kidney function though still reasonable has plunged since I had my thyroid mostly removed. Does...
Raised liver and kidney function 
Can levothyroxine work this quickly?
Hypothyroidism and kidney function 
Can levothyroxine cause acne?
Kidney Function eGFR. Good news.
